Individual
WILLIAM MCRAE MITHOEFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2719
(505) 272-2111
Mailing address
PO BOX 988, EL PRADO, NM 87529-0988
(914) 494-4087
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA2020-0116
NM
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
03/19/2021
Last updated
06/08/2021
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